How I Became a Dietitian, a Fearless Practitioner, and an Entrepreneur

I wasn’t always fearless. Honestly, that required quite a bit of work. I didn’t always think of myself as an entrepreneur, either. My career as a dietitian began organically, but as I took charge of its direction, I came to realize some bits of wisdom along the way.

So, how did I get here?

Foundations of a private practice

Before I started my private practice, I was a brand new dietitian trying to figure out life and what I wanted to do. And to be fair, I didn’t really “decide” to start my own private practice. It was more of an organic thing. I was working full time at a health club and part-time at a hospital. Patients would always ask to see me, and so I asked the hospital, “Do you guys mind if I see patients on the side?” and they agreed to it. In that way, I slowly began a private practice.

I started to see patients “on the side” eleven years ago and launched into private practice a year after that. Early on, I did a lot of consulting to make sure I paid my bills. I consulted for eating disorder treatment centers, substance use addiction facilities, and long term care facilities. I started seeing patients 100% of my time two or three years after I started.

From solo to group practice

I officially developed a group practice about six years in. There’s a local grocery store here in Austin that reached out to me because I took insurance. They said, “Oh hey, I see that you take our provider Blue Cross/Blue Shield. Would you be able to take on 40 new patients starting tomorrow?” I was like, “Oh… Okay!” They wanted to implement a new diabetes education for all their store managers. I had 40 new patients in 24 hours, and I was already full, so I hired another dietitian. She had a full caseload overnight as well.

Realizing I’m a dietitian and an entrepreneur

As these people started coming into the practice, and I started getting more patients, I had to stop and ask myself, “Why am I doing this?” I had to take a step back and think about it.

My “why” for starting out in private practice has been, and will always continue to be, to create better access to dietitians. So many people have questions about what to eat, how to eat— all of that — but most dietitians hate the business side. They don’t want to do the marketing, the advertising, the networking — they want to come in and just be dietitians.

One major frustration is they don’t know how much extra work it’s going to be. They think that they can just open up their doors and people will start walking in. They think, “I have a website. I have an office. I should have clients, right?” I was like “Yeah… bless your heart, peanut. It’s not going to happen like that. You’ve gotta actually do some work.” This is where smart, strategic, and step-by-step marketing with accountability can actually make a practice successful.

People go to school to become therapists and dietitians to help people. They didn’t go to school to be entrepreneurs. They have no idea how to start a practice or how to grow a practice. Me? I love that stuff, too.

Practitioners are often siloed by themselves without a community or officemates. They might not have other people to sit down and have lunch with or “I just saw this client, and this and this and this went on” to be able to have that venting time. That’s another piece that brings a lot of frustration.

About my practice now

We now have seven clinicians on my team. Some of them are transitioning to their own practices, which I think is great. I love that about our practice — we help people figure out how to start a private practice and launch into theirs. It’s been fun to see people learn and grow and integrate into the community and then start their own practices.

At my practice, mainly we love treating eating disorders, addiction, mental health, developmental disorders from the non-diet, health at every size approach. When somebody does want to come in for diabetes, for heart disease, we’re going to treat them on the same vein of taking weight out of the equation. How are you going to nourish your body, take care of your body, take care of your brain, and live?

Nobody came with an instruction manual for their body, so how do you actually do that and do it mindfully? We want to see people because they’re asking for help and we want to make sure it’s in alignment with our values.

Becoming fearless

Fearless Practitioners officially started two years ago. It was this baby dream of mine. It started because I wanted to have a podcast. I love podcasts so much. I was sitting at FNCE® five years ago and decided to start a podcast about eating disorders. There are a couple of podcasts about eating disorders, intuitive eating, and all that. I don’t get a lot of questions from colleagues asking about that, but I get questions asking about running and growing a practice. I realized that I’m good at that. I gradually started to build courses.

It was initially called The iLiveWell Business Academy, which was boring as hell and didn’t fit my personality. Over the last year, I morphed it into Fearless Practitioners. I wanted to reach a broader audience and instill in all types of practitioners how to grow a practice. Growth is one of the hardest pieces that people often forget. Being a mentor, I want to empower more practitioners and create better access to dietitians.

The wisdom of hindsight

I made so many mistakes that I don’t want people ever to make. I want them to have faster growth than I ever did. I want to help people understand how they can grow and have an awesome practice. I love to keep instilling that into people and help them to see the pitfalls that I made and how to kind of steer past that.

My best advice

There’s so much advice that I would give someone starting in private practice. I would say I have two puzzle pieces. First one would be:

“Find other entrepreneurs.”

The entrepreneurs you find can come from inside your specialty as a practitioner, but having other like-minded individuals is helpful. I’m in this accountability group and run a few accountability/mastermind groups, and it has been freaking life changing.

If you’re not familiar, an accountability group is a gathering of people with the purpose of sharing goals, reporting in on progress, and keeping each other accountable. As a practice owner, I have a to-do list that’s probably 40 items long on any given day. It makes me have anxiety. Each week in my accountability group, we have to commit. “I’m going to do three of those things.” Aligning with other entrepreneurs for accountability forces you to get those things done.

The other piece of advice would be:

“Scared money don’t make money.”

If you’re afraid to invest money, you’re never going to make it. You’ve got to spend some dollars. If that’s getting a great client management software… if that’s hiring a mentor… By investing in yourself, it will cause your practice to grow leaps and bounds. I wish I would’ve done that sooner. Invest in yourself and your practice.

Investing in myself

I always tell people that before finding SimplePractice, my practice was held together with band-aids and dental floss. I was of the mindset of “how can I do this for super cheap?” I wish somebody would have told me not to do that because it’s not worth it. I spent more time and even more money that way. I had five different systems going all at once. One for billing, one for scheduling, one for reminders, one for bookkeeping — it would make my head spin.

It was a horrible, awful, total hot mess that took up way too much of my time.

As far as the price, it didn’t look like much money because the trials were free, and I only used those free aspects. If I look at how much it cost of my time — holy hell, that was a lot of money. For about eight or nine years, I used all these different systems and drove myself bonkers. I had an “I hate having all of these systems” realization. It was time for my group practice to come together properly.

There were a couple of things I needed in my EHR and client management software, so I’d ask my friends:

What were they using?

What had they tried?

What did they like?

What did they not like?

I’d use Google reviews to identify products and then sign up for a free trial. The questions I would ask were:

How is the calendar integration?

How is the charting? (I love that you can load previous chart notes to a current chart note that you’re working on)

Does it have insurance billing?

Here in Austin, tech is super big. I had some friends who made EHRs, and I even test piloted theirs. I tried them all. I put four or five patients on different ones. I researched different platforms, and I went with SimplePractice.

Getting there

Is there a magic formula for creating the perfect private practice? I don’t know if that exists, but there are things you can do from the get-go to set yourself up for success. Having the right mindset, establishing a network, and utilizing the right tools will put you on the path. Invest in yourself and understand that, even if you didn’t intend to be one, you are an entrepreneur. Embrace it. Go out and be fearless.